Dr. Sullivan & the AFCC

I am a consultant to a client parent and attorney surrounding the attachment pathology displayed by his child and its treatment.  A recent custody evaluation provided specified referrals for treatment and named Matthew Sullivan, Ph.D. as a primary recommended referral for my client and the child to treat the attachment pathology in the child.

I have been asked by my client to provide an opinion on the referrals offered by the child custody evaluator.  I will be seeking additional information from each of the offered referrals to provide an opinion on their relative merits and my recommendation as a clinical psychologist with expertise in treating attachment pathology in children.

Matthew Sullivan, Ph.D.

Dr. Sullivan is the President of the Association of Family and Conciliation Courts (AFCC).  I am certain this is applied to his credit regarding his asserted “expertise” with court-involved family conflict.  At the same time, the AFCC also endorses the practice of child custody evaluations about which I have prominent professional concerns.

If Dr. Sullivan is to receive credit for his standing with the AFCC, then Dr. Sullivan’s professional judgement and practices should also bear responsibility for any failures in the practice of child custody evaluations. In issuing Model Standards of Practice for Child Custody Evaluations, the AFCC, and Dr. Sullivan as its President, bear responsibility for any failings or flaws to their child custody evaluation assessment procedures.

In addition, the professional background, education, training, and expertise of Dr. Sullivan with assessing, diagnosing, and treating attachment pathology in children (the pathology displayed by my client’s child) also bears relevance to the quality of the referral to Dr. Sullivan for the treatment of the attachment pathology in my client’s child.  While Dr. Sullivan’s professional background in forensic psychology appears substantial, this would not allow him to treat other pathologies such as autism, or eating disorders, or early childhood mental health problems, without additional education and training in those domains of pathology.

My client’s child is displaying severe attachment pathology, and Dr. Sullivan has been offered to the court as an expert in treating and restoring children’s attachment bond to their parent.  I will be reviewing his background education, training, and experience for evidence to support his asserted expertise in assessing, diagnosing, and treating attachment pathology in children, so that I can provide an opinion on Dr. Sullivan’s offered expertise in attachment pathology in children and its treatment.

Critiquing the professional practices of the President of the AFCC, especially when I am such a harsh critic of child custody evaluations, is fraught with professional dangers for me.  I am concerned that if my analysis and opinions regarding the professional practices of Dr. Sullivan are made only through private communication to my client parent and attorney, that Dr. Sullivan will then be denied the opportunity to respond to any misperceptions I may have about his practice.  I am also concerned that elements of my critique may be released that are taken out of context, that misrepresent my opinions, or are inaccurate.

For these reasons, I have decided to make my analysis and opinions public surrounding Dr. Sullivan as a referral resource for my client.  In this way I take full responsibility for the accuracy of my statements and my opinions.  These blogs also allow Dr. Sullivan to correct any misperceptions I may develop surrounding the practices and capabilities of Dr. Sullilvan.

Critiquing and offering an opinion as a clinical psychologist on the professional practices of the President of the AFCC should not be done in haste, and should reflect a proper assessment of the issues involved.  My opinions are my opinions, they do not represent truth.  I have no access to truth except through me, and “me” will always shade my perceptions.  I will allow others to review and discuss, and to reach consensus opinion on where truth lies.  These are my opinions based on the information I describe in support.

If my opinions are in error, I am open to, and invite, correction.

Opening

I will approach my review and analysis of the referral resource for my client and the child across several blogs.  This one will focus on the association of Dr. Sullivan to the practice of child custody evaluations through his role as President for the AFCC.  If his professional expertise in the practice of child custody evaluations is held to his credit, then any failings of child custody evaluations to meet professionally acceptable standards of practice would also attach to his responsibility.

My focus in this blog will not be toward Dr. Sullivan directly.  Dr. Sullivan is an acknowledged expert in the practice of child custody evaluations. This blog will examine what that means, what exactly is the practice of child custody evaluation, is it a valid assessment procedure, is it ethical professional practice.  I have prominent professional concerns as a psychologist that child custody evaluations are neither valid nor ethical professional practice, and instead, the practice of child custody evaluations violate multiple ethical Standards of the APA ethics code.

This blog will present the information on which I base my professional opinions regarding child custody evaluations.  Standard 2.04 of the APA ethics code imposes upon me the requirement that my professional judgments be based on the “established scientific and professional knowledge of the discipline.” I am establishing that foundational knowledge here.

2.04 Bases for Scientific and Professional Judgments
Psychologists’ work is based upon established scientific and professional knowledge of the discipline. (See also Standards 2.01e, Boundaries of Competence, and 10.01b, Informed Consent to Therapy.)

The APA ethics code is not optional.  It is mandatory.  My analysis and my judgments formed surrounding child custody evaluations will be based on the “established scientific and professional knowledge” of…

  • Psychometics and validity of assessment
  • The Ethical Principles for Psychologist and Code of Conduct from the American Psychological Association
  • Cultural psychology
  • Research on bias

These domains represent the “established scientific and professional knowledge of the discipline” on which I will rely.

Overview

In July of 2018, the American Psychological Association posted an invitation for public comment regarding the practice of child custody evaluation.  I submitted a Comment and posted it to my website:

Comment on Child Custody Evaluations

In this Comment offered to the APA, I describe 8 domains of concern surrounding the practice and procedures of child custody evaluations.  In this current description I will add a ninth.

1.) No Inter-Rater Reliability (psychometrics)

Child custody evaluations have no inter-rater reliability.  Zero.  The inter-rater reliability for the conclusions and recommendations reached by child custody evaluations is zero.  If an assessment procedure is not reliable (stable in its findings), then it cannot, by definition, be a valid measure of anything.  Two child custody evaluators can reach entirely different conclusions and recommendations based on exactly the same data.

The conclusions and  recommendations from child custody are not valid because they are not reliable, there is no inter-rater reliability.

2.) No Established Validity (psychometrics)

There is no research ever conducted to establish the validity of the conclusions and recommendations made by child custody evaluations (face validity, construct validity, content validity, predictive validity, concurrent validity, and discriminant validity).

Since there is no demonstrated validity for the conclusions and recommendations reached by child custody evaluations, then the conclusions and recommendations from child custody evaluations are not valid.

3.) No Operational Definitions for Constructs (psychometrics)

Child custody evaluations have no operational definitions for either of their key constructs, the “best interests of the child” and “parental capacity.”  Without operational definitions for the constructs, the assessment is unreliable and prone to the whims and biases of the evaluator (both conscious and unconscious).

Without operational definitions for its key constructs, the conclusions and recommendations reached by child custody evaluations are not valid.  They simply represent the opinion and biases of one person.

4.) Violation of Principle D Justice (ethics)

Principle D: Justice
Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists.

Equal Access/Equal Benefit:  At a cost of $20,000 to $40,000 per child custody evaluation, the financial costs of the assessment procedure make it unavailable to anyone other than the most affluent of clients who can afford the excessively burdensome financial cost.  This would be in violation of the requirements of Principle D Justice for “equal access to and benefit from the contributions of psychology” since lower socio-economic families are denied “access to and benefit from” the child custody input of professional psychology provided to more affluent parents and families.

Equal Quality: The absence of inter-rater reliability and standardized interpretation of clinical interview data result in highly variable quality in the conclusions and recommendations reached by custody evaluation procedures across evaluators.  This variability in quality is in violation of the requirement of Principle D Justice for “equal quality in the processes, procedures, and services being conducted by psychologists”

Two prominent forensic psychologists, who literally wrote the book on child custody evaluations, Stahl and Simon, acknowledge and describe the high degree of variability in the quality of child custody evaluations:

From Stahl & Simons:  “The American Board of Forensic Psychology is a subspecialty board of the ABPP.  In the fall of 2011, there were approximately 250-300 ABPP board certified forensic psychologists in the United States and an unknown number of psychologists who specialize in forensic work but are not board certified.  On top of that, there are many psychologists who dabble in forensic practice, occasionally performing child custody or other types of forensic evaluations, and who find themselves called to testify in court on occasion. While we recognize that there is a range of quality in their work, it is clear that forensic psychology is a growing area of specialization.” (Stahl & Simons, 2013, p. 9)

Stahl, P.M. and Simon, R.A. (2013). Forensic Psychology Consultation in Child Custody Litigation: A Handbook for Work Product Review, Case Preparation, and Expert Testimony, Chicago, IL: Section of Family Law of the American Bar Association

“…many psychologists who dabble in forensic practice…”  That psychologists “dabble” in severe and highly complex family pathology is deeply distressing surrounding compliance with Standard 2.01a Boundaries of Competence.  This admission by Stahl and Simon, leading figures in forensic psychology, is not reassuring that child custody evaluators who merely “dabble” in working with a pathology possess the necessary professional competence needed for assessing complex family conflict.

Is this then the new standard for professional competence, that psychologists can enter a field to dabble in treating autism, dabble in treating eating disorders, dabble in treating panic disorders, dabble in treating trauma, is that the standard for professional competence established by Standard 2.01a Boundaries of Competence?

Even more disturbing than this open admission regarding the “range of quality in their work,” is the seeming cavalier disregard for the potential negative impact of this “range of quality” on the clients.  Stahl and Simon appear to instead accept this wide “range in quality” from psychologists who merely “dabble in forensic practice” as a good thing because it indicates that the industry of conducting (invalid) child custody evaluations is growing:

From Stahl & Simon: …while we recognize that there is a range of quality in their work, it is clear that forensic psychology is a growing area of specialization.”

It would appear that forensic child custody evaluators are more concerned for their financial success and the growth of their industry than they are in the quality of care they provide to their patients.

5.) Unanswerable Referral Question (bias)

Assessment is always to answer the referral question.  The referral question for assessment accepted by child custody evaluators is, “What should the child’s custody schedule be?”  This is an over-broad and unaswerable referral question by any information existent in professional psychology.  No one knows, it is impossible to answer.

Because there is no answer possible, whatever answer is given is merely a guess made by one person based on nothing of substance in particular.  Just their guess, of that one person.

The key criteria for determining the custody visitation schedule are the “best interests of the child.”  However, this key construct to the assessment is undefined and fundamentally undefinable by any information existent in professional psychology.

Again, Stahl and Simon describe the fundamentally undefinable nature for the construct of the child’s “best interests”:

From Stahl & Simon: “A critical subject facing those working in the field of family law, whether they’re legal professionals or psychological professionals, is the concept of the best interests of the children.  Even recognized experts in this concept differ with regard to what it means, how it should be determined, and what factors should be considered in determining what is in the best interest of a child.  Thus, this ubiquitous term escapes consensus and remains fundamentally vague. (Stahl & Simon, 2013, p. 10-11)

From Stahl & Simon: “It is defined differently from state to state; and even in Arizona, where there are nine statutory factors associated with the best interest of the child, the meaning behind many of the factors is obscure.  Additionally, when psychologists refer to the best interests of children, they are referring to a hierarchical set of factors that may have different meanings to different children with different families and that may be understood differently by psychologists with different backgrounds and different training.” (Stahl & Simon, 2013, p. 11)

This inability to define the basic fundamental criteria for the evaluation invalidates any conclusions and recommendations reached by the child custody evaluator.

6.) Cultural and Personal Bias (bias)

That the construct so central to the assessment is fundamentally undefined, opens the assessment process to distortion by a variety of evaluator biases, including both cultural biases against differing value systems in parenting, or the different ethnicities of the parties, or the different genders of the parties, as well as counter-transference bias from past family of origin or personal marital-spousal issues (e.g., the mother reminds the evaluator of his ex-wife, or the evaluator never had a bonded relationship with their parent and this influences their perceptions and judgements).

The only justification for restricting a parent’s time and involvement with their child is a child protection concern.  If there is child abuse, diagnose child abuse (DSM-5: V995.54 Child Physical Abuse, V995.53 Child Sexual Abuse, V995.52 Child Neglect, V995.51 Child Psychological Abuse) and protect the child.

If there is no child abuse… then parents have the right to parent according to their cultural values, their personal values, and their religious values.  It is exceedingly problematic when psychologists assume a role of deciding if a parent “deserves” to be a mother or father based on non-defined criteria (the best interests of the child) when there is no diagnosis of child abuse.

7) No Oversight or Review

The individual practices, conclusions, and recommendations of individual child custody evaluations receive no separate review or oversight. Unlike a clinical diagnosis and decision-making based on DSM-5 and ICD-10 diagnoses that are subject to a second opinion review, the decisions emerging from child custody evaluations are un-reviewable, they are sealed by the court, and the prohibitive cost ($20,000 to $40,000 each) and length of time needed (six to nine months each), prevent any second opinion.

Child custody reports are never reviewed for accuracy or for applied professional standards of practice.

As a clinical psychology consultant to parents and attorneys regarding treatment of attachment-related pathology, I have had the opportunity to review the child custody reports for my clients to assist in treatment plan development.  The child custody reports I have reviewed have consistently been substantially beneath acceptable standards of practice in clinical psychology assessment, often reach deeply troubling conclusions and recommendations that are entirely unsupported by their reported data, and that often contain prominent indicators of clear bias in interpretation.

I will offer two of the most egregious examples of the problematic professional standards of practice I have encountered.

Example 1: MMPI 4-6-9 Elevation

I reviewed one child custody report in which the father received an MMPI elevation on three scales; 4 Psychopathic Deviant, 6 Paranoia, 9 Mania (Narcissism when elevated 4).  The MMPI is not a personality measure, it is a pathology measure.  When it identifies a pathology – it’s not personality, it’s pathology.

The father was identified by the MMPI as potentially having psychopathic-narcissistic spectrum character traits with prominent paranoia. The mother’s MMPI was entirely normal.  The children’s chief complaint against the mother was that she fed them leftovers, so their dad had to come over when they called him and bring them take-out food because they hated their mother’s cooking.  They never wanted to see their mother again, because she was a bad cook and fed them leftovers. I kid you not, documented fully in the child custody report, that was their chief complaint.  Father had a 4-6-9 elevation on the MMPI, mother’s MMPI was entirely normal.

The custody evaluator never elaborated on the 4-6-9 MMPI elevation beyond a one-paragraph standard nondescript horoscope-type general description, and awarded full custody to the father and placed the children on restricted visitation with the mother and… “reunification therapy.”  No review.  No oversight.  No reason given.

Example 2: Lazy Forensic Psychologist

Lest you think that is an isolated example, I reviewed one child custody evaluation that was nothing more than a transcript of the “interviews” with the family members, entirely quotations throughout, with only connecting sentences provided by the custody evaluator to the transcript.

No discussion, no analysis, nothing.  The custody evaluator simply block quoted the verbatim transcript as the entire body of the report, and then made a three-paragraph pronouncement that lacked any proffered reasoning or justification, simply three paragraphs of personal conclusions and recommendations (the substance of which was deeply concerning because they were apparently wrong, based on the information provided in the transcripts).

So distressing were the professional practices exhibited by this child custody evaluator that I redacted the evaluation report and posted it to my website for educational purposes – this represents standard of practice – actually “high quality” standard of practice, for child custody evaluations.

I redacted all direct quotes as blue and all original sentences in red.

Lazy & Slothful Forensic Psychologist

I can have a high-school kid audio record people’s complaints, get it transcribed, and give me a random opinion based on nothing in particular.  I’m sure they’d be a lot cheaper than the $20,000 to $40,000 for a child custody evaluation, and likely be more accurate. Still no inter-rater reliability though.

Notice the signature line for this child custody evaluator,

“Diplomate of the American Board of Assessment”

I wonder if the American Board of Assessment knows this is the quality of work produced by one of their Diplomates?  Is this what they train them to do, record, transcribe, and give a three-paragraph pronouncement based on nothing?

This is a “high-quality” forensic child custody evaluation, by one of their “Diplomates in Assessment.” This is one of their good ones.

A (volunteer) Professor at a Prestigious School of Medicine and Institute

I wonder if the prestigious School of Medicine and Institute knows that this is the quality of professional work that they are being associated with through a “Volunteer” Professor (what exactly is that?).

This is one of their “good ones” – from a “Diplomate in Assessment.”

These are two examples, unfortunately, they are not a-typical.  No review, no oversight, $20,000 to $40,000 for each evaluation, combined with people who merely “dabble” in child custody evaluations, breeds ignorance, sloth, and incompetence throughout the “industry” of child custody evaluations.

8) The “Custody Prize”

When we make the child’s “voice” and expressed opinions the basis for our decisions surrounding child custody and visitation, we essentially turn the child into a “custody prize” to be won by who can prove that they are the “better parent.”  The judge in this matter of who is the “better parent” is the custody evaluator, who will go through a ritualized (and expensive) set of procedures to make a determination of which parent is the winner of the “custody prize” – the child.

Each parent must not only plead their case to the custody evaluator to choose that parent as the “better parent,” but the value placed on the child’s voice means that appeasing the child and getting the child to align with that parent’s side in the marital conflict will ensure that the custody prize goes to the parent who is better able to seduce and coerce the child into verbally taking that parent’s “side” in the marital-custody conflict.

The child’s voice is now a prize to be one.  On your mark, get set, go… go convince the child to be on your “side” – whoever wins the child’s voice will be the winner of the custody prize. Okay, times up.  Now go visit the custody evaluator and “Plead Your Case.”

Oooo, I’m sorry, it’s a draw, no decision.  You’ve been sent to the “Reunification Therapy” doldrums.  You’ll need a Second Child Custody… Reevaluation… by the SAME custody evaluator as last time, because after two years of the “Reunification Therapy” doldrums, the child’s pathology has gotten WORSE.

It is not the role of psychologists to sit in judgement of parents to determine who is the “better parent” to be awarded the “custody prize” of the child.  And psychologists should know better than to give uncritical substance to the child’s expressed “voice,” and should apply a broader analysis to the data.

9) Intentionally Withholding Relevant Information from the Court and Litigants (ethics)

Child custody evaluators are directly instructed by the AFCC to withhold relevant information from the courts and the litigants.  Standard 4.6c of the Model Standards of Practice for Child Custody Evaluations published by the AFCC directs child custody evaluators to withhold information about “diagnostic labels” from the court and from the litigants.

4.6 Presentation of Findings and Opinions

c) Evaluators recognize that the use of diagnostic labels can divert attention from the focus of the evaluation (namely, the functional abilities of the litigants whose disputes are before the court) and that such labels are often more prejudicial than probative. For these reasons, evaluators shall give careful consideration to the inclusion of diagnostic labels in their reports. In evaluating a litigant, where significant deficiencies are noted, evaluators shall specify the manner in which the noted deficiencies bear upon the issues before the court.

By “diagnostic labels” I assume they mean “diagnostic labels” such as V995.51 Child Psychological Abuse and ICD-10 F24 Shared Psychotic Disorder (a shared delusional disorder with the parent as the “primary case” – the “inducer”; American Psychiatric Association, 2000).

Withholding a “diagnostic label” of child psychological abuse and a shared persecutory delusion between the child and the allied parent from the court’s consideration is a deeply troubling instruction for the AFCC to give to their child custody evaluators.

Do they make a similar policy regarding withholding the “diagnostic labels” of schizophrenia or bipolar disorder from the court’s consideration as well?  Or is this policy to withhold information about “diagnostic labels” a matter of personal choice left up to the individual discretion of each custody evaluator, to weigh and balance the “probative” value of the “diagnostic label” for one litigant’s case versus the potentially “prejudicial” impact that the “diagnostic label” will have on the chances of the pathological parent to obtain custody of the child.

This is a decision specifically instructed on the child custody evaluator by the AFCC, to determine the probative value for one litigant versus the prejudicial impact of the “diagnostic label” for the pathological parent, and if the child custody evaluator decides that the “diagnostic label” is too substantially “prejudicial” to the chances for the pathological parent to gain custody of the child, then to withhold this information from the court.

What is perhaps even worse, is that child custody evaluators also withhold this relevant diagnostic information about the parent’s “diagnostic labels” from the litigants. This means that the court does not obtain this information about the “diagnostic label” of one parent, and the litigant for whom it may have “probative” value is denied access to this information as well, so they cannot provide this potentially “probative” information to the court.

The child custody evaluator is essentially being told by the AFCC through Standard 4.6c of the Model Standards of Practice for Child Custody Evaluations to make a prior decision on the probative and prejudicial impact of a “diagnostic label” and then to disclose or entirely withhold this information from both the court and from the litigants involved, so no one ever knows, and no one can challenge this prior-decision made solely and secretly by the child custody evaluator.

This is a deeply troubling over-reach from the psychologists ethically, and while I am not a legal professional, it seems an inappropriate abrogation of the court’s role and authority in evaluating the evidence, and the rights of the litigants to present to the court unbiased evidence.

The child custody evaluator is instructed by the AFCC to put their finger on the scales of justice without the court’s knowledge, and tip the scales in favor of the pathological parent by withholding the “diagnostic label” for the pathological parent from the court’s consideration and the litigant’s knowledge.

Conclusions

For these nine reasons, I am deeply troubled by the practice of child custody evaluations as practiced by forensic psychologists and as advocated for and instructed by the AFCC.

My website contains an area where I describe a variety of my concerns surrounding child custody evaluation:

drcachildress.org: Attorneys – Child Custody Evaluations

Dr. Sullivan is the President of the AFCC who produce the Model Standards of Practice for Child Custody Evaluations. The AFCC actively supports the practice of child custody evaluations, and it is assumed that Dr. Sullivan is also an established practitioner of child custody evaluations.

Any prior bias I may have in my assessment of Dr. Sullivan as a resource for resolving parent-child attachment pathology is acknowledged by these nine points, and I invite Dr. Sullivan to provide response to my concerns that will reassure as being unfounded.  I am concerned, however, because each of the nine concerns is substantial, each appears warranted, and any of the nine by itself would warrant the discontinuation of the practice.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Smile. yes, you. Smile. doctor’s orders.

Change isn’t hard, it’s just doing something different.  It’s not hard, it’s just different.  We don’t like to do stuff that’s different, it’s not comfortable, it’s different, the same is comfortable.  I know what the same is.  I may not like the same, but I do know what it is. And that’s comfortable, because it’s the same.

Change is just doing something different until it becomes the same.  How do you do that?  

Do you want to know how to do that, to make changes, to become different?  I can tell you if you want know the secret to change, it’s not very complicated.  You’ll be impressed by how simple it is.  And you won’t want to do it, because then things will be different and you don’t like different because we like to be comfortable.

Do you want me to tell you?  I can.  Okay, here’s the secret to change.

Do something different.

Didn’t I tell you that you’d be impressed with its simplicity?  And didn’t I tell you that you wouldn’t want to do it?

Change is not hard, we just don’t want to do it.  For example, say you’re a couch-potato unhealthy mess.  You want to change.  What do you do?  Start doing something different.  Go to the gym.  Oooh, I hate the gym.  Who cares, just go.  So you go, and you go, and you go, and soon, what was different, and you go, and you go, becomes the same, and you go, and now, it feels good to go to the gym.  You want to go to the gym because it feels good.

Or say you want to learn the piano.  What do you do?  Start taking piano lessons.  Oh my god, you’ll be awful, absolutely awful.  Who cares, just keep plunking away… you practice, and you practice, and it’s sooo boring, and you practice and you practice, and it’s not even close to music, and you practice and you practice, and now it’s turning into music, and what was different is becoming the same, and you practice and now you’re playing the piano.

Everything works that way.  It’s not some big Freudian secret, if you want to change, do things different.  Doing things the same will not lead to change.  Doing things different is the secret to change.

But you don’t want to do it, I know. 

What you’re doing when you do things different is you’re grooving in new tracks in your brain, like little groove thingies in the circuitry wiring.  Each time you do something it lays a little grove, like a raindrop down a dirt hill, it leaves a little groove.

Other raindrops can go different ways, but if a lot of raindrops keep going down one path, that path gets deeper and deeper.  That’s how our brain works, we groove in the neural networks.  Wanna hear the ten-dollar word… long-term potentiation… ain’t that a mouthful.  That’s the term for the grooving in process.

The ten-cent word is habit.

It’s also called use-dependent development – we build what we use.  Every time we use a neural network it gets strong, faster, and more efficient.  If we use problematic networks (do stupid things and make poor decisions), these networks become stronger, faster, and more efficient.  We get better at making mistakes and getting ourselves into trouble… because we keep doing it, and… because we keep doing it… we keep doing it.

We build what we use.

So how do we change?

First… stop doing the bad thing.  Whatever the bad thing is, don’t do that anymore because you are only grooving it deeper and deeper every time.  So put a big boulder in that groove, you are NOT going down that groove.

Uh-oh.  That’s the only groove you have.  You’ve been struck in that groove since the dawn of time, it’s the Grand Canyon of grooves in your brain, all other grooves in your brain feed into that single groove.

I don’t care.  Do something different.

What?

I don’t care, just so it’s different.

Ahhhh, okay, okay, ahhhh, it’s so different and I don’t know what to do.

What do you want to do?

You’re free. 

But every single time a single nerve cell lights up in your brain, it is going to head directly for that mother of all grooves, the bad one.  What do you do?  Don’t do the bad groove, that only makes it deeper, do something different?  What?  I don’t care, just so it’s different.  Ahhh, okay, well, what, what…

What do you want to do?

Is it hard to go to the gym?  Yes.  Do you want to go to the gym?  No.  Do you go to the gym?  Yes.  Why?  Because it’s different.  The same is sitting on the couch.  Do not-that.  So then what?  I’ll go to the gym.  I hate the gym.  Who cares, just go, and go… see?  Grooving in the brain circuits.

Piano, same thing.  Or how do you learn math?  Do it over-and-over, all the time, you groove in the “doing math” circuits in the brain, use-dependent development.

Two parts, 1) stop doing the bad groove, it only makes it deeper, 2) start doing something different.  What?  It doesn’t matter, as long as it’s different (don’t worry, you’re a smart human, you’ll figure out the what – what do you want to do?)

Change isn’t hard, it’s actually quite simple.  Do things different.  If you do things the same, that’s not going to be change, that’s just the same.

But change is scary (ahh-ahh, it’s not the same, it’s different), but don’t worry, we’re smart humans, we’ll figure it out.  Once you leave the groove, you’re… free.

But we don’t want to be free, too much pressure.  It’s more comfortable in our grooves.  We may not like our grooves, but they’re ours, and they’re comfortable…. kind of a familiar suffering.

I want to give you a gift. I’m not sure you’ll take it, but maybe.

I want you to smile.

More often, a lot as a matter of fact.  Not because you feel happy.  I don’t care how you feel.  Did I say I want you to feel happy?  No.

I want you to smile.

For no reason whatsoever.  I know, amazingly silly.  I don’t care, just smile.  More.

How many times do you smile a day?  Three times?  Five times?  Zero times?  Whatever it is, I want you to smile three times as much. So if you smile zero – smile three times a day, for no reason whatsoever and yes you will look like a lunatic.  I don’t care.  Just smile, for no reason whatsoever.

If you smile twice a day, smile six, three times, smile nine… oh my god, Dr. Childress, stop, you’ll have me smiling all the time.

Exactly.  Maybe not all the time, but pretty close.  Why?  Use-dependent development, we build what we use.  I’m gifting you a brain-hack, a back-door.  There’s this little kink in the neural networks that we can take advantage of… we’re stupid.

Our brain doesn’t know how we feel.  So when we smile, our brain registers the muscle movement of the smile, but when it goes to look at emotions there’s no happy.  What’s up with that?  So the brain calls down to emotions and says, “Are you happy?”

And emotions says, “No, not really.”

“Well, we’re smiling, so we must be happy.  Give us some happy.”  So emotions produces a little pop of happy, called endorphins for the ten-buck word.  We trick the system into thinking it’s happy.  Emotions and body are linked, we just ran up the backside of the system.

We smile when we’re happy… and we’re happy when we smile, either way.

Then… we use use-dependent development, just like playing the piano, just like going to the gym.  What happens when you go to the gym over-and-over again, you get all buffed-out and strong.  What happens if you practice the piano over-and-over again, you’re playing jazz riffs at the Christmas party.  So then smile.

Smiling is a whole lot easier than going to the gym and practicing the piano, and way-way more fun.  You’ll feel silly.  I don’t care.  You’ll look silly.  Doesn’t matter.  Apologize if you look creepy, tell them “doctor’s orders.”  Doesn’t matter, just smile, for no reason at all.

Do it in the car while you’re driving to and from work.  You have all kinds of time driving.  You’re brain doesn’t care when you practice “happy” – car’s a great time.  Just smile.  “But I don’t feel happy.”  Just smile anyway.

Do it over-and-over, practice the piano over and over and what happens?

Are you terrible at the piano when you start?  Yes.  Does it matter?  No. 

It is as simple as just doing something different.  Smile.  More.  Again…. and again… and again.  I don’t care whether you feel happy, you will become happier.  Not an ecstatic find-god sort of happy.  But your brain systems for the happy emotion will become stronger, faster, and more efficient.  That’s a nice thing.

You will become happier (stronger), more often (faster), and that feeling just sort of happy feeling will become a way of life (more efficient).  That’s not a bad outcome from smiling for no reason in the car to-and-from work. 

Before going to bed, from the time you enter the bedroom to the time you crawl under the covers, I want you to smile three times – doctors orders.  Three times before bedtime

Doctor’s orders:  Patient needs to increase the long-term potentiation and synaptogenesis along the neural networks for the up-arousal and social-bonding affect systems for joy and laughter. 

You need more joy and laughter, doctor’s orders.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

The Voice of Children, for Children.

I do not seek the voices of the children, children are neutral.  We will fight and win this battle with pathology without relying on the child’s voice.  We will find other ways, children are neutral.

Yet the adult children who have recovered themselves from their devastated childhoods of loss created by the pathology of one parent, can carry the voice of and for the child.

This speaker is anonymous to me, and that’s the way it should be. She speaks for all children of alienation. This pathology is devastating for the children, and it moves in them for a lifetime, a childhood destroyed, a lifetime altered, a lifetime of enduring grief and loss.  This is the voice of the child.  Listen.

Dorcy Pruter is also that child.  She’s not a psychologist or a mental health professional, she was that child.  She too was abandoned to the pathology of one parent that alienated her from the other.  She also had to self-recover because of the failure of professional psychology.  She became determined to end this for every child.

Amanda’s voice.

 

Dawn’s voice

I recently received this email from Dawn Endria McCarty, Chair, National Parents Organization Florida and Associate Producer for the documentary, Erasing Family.  I found her email to me spoke with the authenticity of that child, the voice from and for the children of alienation.  I asked and received her permission to post her email to me on my blog.

In addition to her work to bring an end to this devastating family pathology, she was that child.  Ms. McCarty is a survivor of childhood alienation.

These now-adult children, like Dawn McCarty, are coming forward to speak.  It is time to listen to this voice from the authentic child.


From Ms. McCarty:

Dr. Childress,

It’s a pleasure to be introduced to you directly and I want to thank you for sharing your work so generously.  As I watch your videos or read your posts to learn as much as I can from you, I have realized that for me, I take something away that is probably a little different than most, because I learn more about myself, than anything else.  I am an adult child that experienced the emotional cutoff that you speak about and I was just telling Paul, that what I learn is that my experiences and feelings from the trauma I endured are validated and I have a deeper understanding of what really took place.   I was abducted and erased from my father in 1972 and the world as I knew it vanished overnight.  What that world was replaced with is what I have referred to over the years as my personal “Twilight Zone”, which I could never reconcile it in my head without help.

After a 44-year search, I finally found my father January 29, 2016 and together we were able to do some much-needed healing.  I believe it is important for others to know is that a child cannot heal holistically without their erased parent, they need each other to really heal.  Before I realized this, I never thought I had a purpose, but I have learned otherwise over the last 3 years.  Thru the emotional roller coaster of feelings during the time I had with my father, I finally realized that there was a reason that I was able to survive the trauma as I did, and that is to share what I experienced now.  To expose and oppose those that believe they are only thinking about the “best interest of the child”.   I can dispute many of these arguments, where they are not able to dispute mine, because they are not thinking about the long-term effects of the child. They are only applying a band-aid to a wound that will never heal without the proper people and tools.

The turning point for me was when I lost my father again on January 19, 2018, only permanently this time.  I am a member of the unpopular group of people that have lost someone dear to them twice in one lifetime.  As we educate and reconnect children to their erased parents, there is potential for the membership of this group to grow if we don’t change and protect the child’s inalienable rights to love and be loved by both of their parents.  I feel a loss, yes, but I also feel extremely blessed that I was able to spend those last two years with him before he left this world. I am fortunate in that respect, however for others, that means there is no time to waste, we must change now for the children of today. 

I became a GAL and also participated in a few studies on the effects of abductions or emotional cutoffs, however they are hardly adequate for use by the United States to the degree we need them to be.  To my knowledge there are no studies conducted on the long-term effects of childhood trauma that follows the children throughout their lives.  We know that children do not outgrow their trauma, they do not get over it, they just suppress it.  We know that these effects do not go away, even when on the outside there is nothing apparently wrong.  It just sits idle in Pandora’s Box waiting for the trigger to be pulled and not many are ready or equipped with the needed tools to process these emotions.  Not when it is like a firehose on full blast, aimed at their heart.  It is my hope to get NPO to conduct a study of these long-term effects in the near future.

It is very true that you are working ahead of everyone else, as you mention in your posts.  Your research, education, and communications validate the long-term effects that I felt as a very young child, growing into a young adult, and far into being a grown woman.  By laying this out now, the way you have, means when we finally do get to conduct studies, there will be a model to follow.  In combination with future studies, I hope it will help identify the issues a child faces throughout their lives.  What I went through when my pandora’s box blew open was almost more than I could handle.  I am strong, yet I still had trouble handling this, which makes me fear for the ones who are either too fragile, the young children, the vulnerable, or those who are shattered from the trauma. I am sharing my experiences by speaking and educating for them, which is quite possibly the missing key to the argument. I am trying to be an open book to allow others to have an example to study and ask questions, although I still have my trauma brain struggles from time to time. But I promise to keep at it.  

That said, I am the chair for the National Parents Organization of Florida and as such, I am planning a Shared Parenting Conference this year with a Premiere of Erasing Family to officially kick of the Impact Campaign that Michelle Stegall-Jordan has implemented. I work closely with her and she has been coaching me both personally and professionally.  We have so many great resources and I am a huge collaborator of sharing and tapping into the tools and expertise that are effective. I have already had three screenings in the state with 3 or 4 more in the works and my hope is that with the attention we gain from Impact Campaign and hosting a statewide conference for equal shared parenting, we can get things rolling in our state legislatively by next year.

One member of my NPO team is Leslie Ferderigos (aka Lawyer Leslie and the “Alienated Kids” videos), whom you reached out to regarding a shared parenting conference in our state.  We would love to have you attend, if you are available.  We are teaming up with Danica Joan (Custody Matters) for a conference on April 24th and will probably have at least one other later on in the summer or fall.  If you can make the April conference, that would be fantastic, otherwise I can work with your schedule for the timing of the other conference later in the year.

I am looking forward to learning from and hopefully working with you more in the future.

Warm regards,

Dawn Endria McCarty
Chair, National Parents Organization Florida
Associate Producer – Erasing Family

dawnendriamccarty@nationalparentsorganization.org


I am unable to attend the conference in Florida on the 24th because I will be returning from my seminars with Dorcy in Ireland in April.  I hope to be in Florida in the future. 

The world is changing.  It needs to change.

I will not place any of the burden for change onto the child. That is our responsibility.  I’m fine with that.  Empathy, make it easy, no worries.  There are others, though, who were that child.  Who understand that child.  Who speak with that child’s voice.

We need to listen to that voice, the voice of the authentic child.  We need to bring them solutions for the entire family, to return to them a childhood of love and bonding, for all children, everywhere.

Empathy.  Simple empathy.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Dr. Childress: Cyberspace Office

I have entered cyberspace. 

Cyberspace Office: my online office is at doxy.me/drchildress

Dr. Childress: Cyberspace Office

Scheduling Calendar: I have an online Scheduling Calendar for scheduling consultation appointments with me:

Dr. Childress: Scheduling Calendar

Website Description:  I further describe my Cyberspace Office & Telepsychology practice on my website:

Dr. Childress Website: Cyberspace Office & Telepsychology

Encrypted Email:  I have encrypted email through Hushmail.com

Dr. Childress Secure Email: drchildress@hushmail.com

California Residents:  I am licensed as a psychologist in California, so there are no restrictions on my ability to practice with California residents through telepsychology.

Non-California Residents:  Jurisdictional limitations on licensure restrict my ability to provide online psychotherapy with non-California residents using a telepsychology platform.  I can, however, provide limited-scope professional consultation with non-California residents (I am limiting this consultation to two sessions).

Professional-to-Professional:  There are no restrictions on my ability to provide online consultation to other mental health professionals or legal professionals.

Online Mental Health Consultation

My consultation with other mental health professionals can occur separately through my Cyberspace Office or can occur directly in their session through my telepsychology platform (with the proper permissions and agreement of the involved parties).  There are two implications of this;

1.) Parent-initiated Consultation: The targeted parent can, with the prior permission of the therapist, bring me to an appointment with the involved mental health professional for direct telepsychology mediated consultation, or can schedule a separate appointment time with the therapist at the Cyberspace Office of Dr. Childress.  We can meet in their brick-and-mortar office or at mine in cyberspace, whichever is preferred.

2.) Therapist-Initiated Consultation: The therapist can request the direct in-session telepsychology consultation of Dr. Childress with the child or select clients, with the proper agreement of the involved parties.  Again, this can occur in their brick-and-mortar office or at mine in cyberspace, whichever is preferred (note: I do not meet with children at my Cyberspace Office only, my consultation that includes direct contact with the child must include a mental health professional in the room with the child).

MH Professional Cyber-Office Consultation

I can meet through my Cyberspace Office with the involved mental heath professional alone, or with the therapist and client.

Therapist Alone:  If desired, I can meet with just the therapist at my Cyberspace Office to consult on a case.

Therapist & Client:  If desired, I can meet with the therapist and up to three additional clients in my Cyberspace Office.

Direct In-Session Consultation: Parent Initiated

Parent-initiated direct in-session telepsychology consultation with the involved mental health professional requires the following steps:

1.)  Initial Consultation:  Schedule an online consultation appointment with Dr. Childress to provide background information on the surrounding circumstances and to obtain guidance on the possible professional-to-professional consultation involvement of Dr. Childress in your matter.

2.)  Permission: If professional-to-professional consultation appears indicated from the initial consultation, then the next step is to obtain the permission and agreement of the involved mental health professional for the in-session professional consultation.

3.)  Confirmation: Dr. Childress will then send an email to the involved mental health professional confirming my cyber-attendance and telepsychology consultation at the next session.

Direct In-Session Consultation: Therapist Initiated

A mental health professional can schedule a direct in-session consultation with Dr. Childress with the proper permissions and agreements of the involved participants.

Therapist & Targeted Parent:  The direct telepsychology in-session participation and consultation of Dr. Childress can be with the therapist and targeted parent.  This would only require the consent of the targeted parent.

Therapist & Allied Parent:  The direct telepsychology in-session participation and consultation of Dr. Childress can be with the therapist and allied parent.  This would only require the consent of the allied parent.

Therapist & Child:  The direct telepsychology in-session participation and consultation of Dr. Childress can be with the therapist and child. This direct in-session telepsychology consultation with the involved mental health professional would require the consent of both the targeted parent and allied parent (each consenting for the child’s participation).

Therapist & Targeted Parent & Child:  The direct in-session participation and consultation of Dr. Childress can be with the involved therapist, the targeted parent, and child.  This direct in-session telepsychology consultation with the involved mental health professional would require the consent of both the targeted parent and allied parent (each consenting for the child’s participation).

Exceptions to Consent:

Exception 1:  If one parent has been given court-ordered sole authorization to consent for the child’s treatment, then the child’s participation in a direct in-session telepsychology consultation with the involved mental health professional and Dr. Childress would only require the consent of this authorized parent.

Exception 2:  If the court orders the direct in-session telepsychology consultation participation of Dr. Childress, then court orders supersede parental consent.

Standard 3.09 Cooperation with Other Professionals

The relevant Standard from the APA ethics code governing professional-to-professional consultation is Standard 3.09 Cooperation with Other Professionals.

Standard 3.09 Cooperation with Other Professionals
When indicated and professionally appropriate, psychologists cooperate with other professionals in order to serve their clients/patients effectively and appropriately.

Court-Ordered Professional-to-Professional Consultation

If the court desires, the court can order the involved mental health professionals to consult with Dr. Childress through telepsychology.  The court may order that the telepsychology consultation only be with the involved mental health professionals, or the court order can include additional family members dependent upon the court’s wishes.

Court orders regarding the telepsychology consultation of Dr. Childress should be sent to Dr. Childress by secure email (drchildress@hushmail.com) when the consultation appointment is scheduled.

Consultation with Legal Professionals

If attorneys wish to consult with Dr. Childress on any matter, they can schedule a consultation appointment through the Scheduling Calendar.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Limbic System: Robert Sapolsky Stanford Lecutures

Robert Sapolsky is a valuable resource of knowledge.  He has a set of Stanford University  lectures on YouTube regarding various aspects of his field, taught from his undergraduate course at Stanford University in 2010,

It’s free, it’s available on YouTube, search on Dr. Sapolsky’s Stanford Lectures:

YouTube: Robert Saposky Stanford University Lectures

All mental health professionals working with court-involved family conflict must watch Robert Sapolsky’s Stanford lecture on the limbic system.  It is free, it is available, it is your introduction to the limbic system.

YouTube: Dr. Sapolsky Stanford Lectures: Limbic System

Attend to statements about the amygdala, frontal cortex, and anterior cingulate.  Attend to the James-Lange theory of emotion, and the role of interpretation and attribution for a bodily state.

Dr. Sapolsky’s lecture on the Limbic System is mandatory.  From this point on, I will assume that all court-involved mental health professionals will be familiar with all of the material discussed by Dr. Sapolsky in this lecture.  The remainder of his 2010 course at Stanford University on YouTube is “optional” – a post-doc of mine would watch the entire course, knowledge is a good thing when working with children.

Child Development Knowledge

Mental health professionals working with complex family conflict surrounding divorce must understand child development.  In 2020 this is substantially more than Erickson’s stages of basic trust vs basic mistrust, industry vs inferiority, from the 1940s.  Since 1990, understanding child development means understanding the neuro-social development of the brain during childhood,

They are inseparable.  Childhood is the period of brain maturation.  To understand childhood, and importantly, the different phases of childhood and the different socio-neurological developmental tasks-challenges for that period, requires – requires – an understanding for the neuro-development of the brain in childhood across different developmental levels.

If the mental health professional does not want to learn the neuro-development of the brain during childhood, that’s fine – just don’t work with children.  Work with adults.  Because since the 1990s, child development has required a professional understanding of the neuro-development of the child.

This is not optional knowledge – knowledge of child development when working with children – it is required knowledge.

Robert Sapolsky’s Standford University course lectures on YouTube are an exceptionally good introduction.  Of central importance is information about the limbic system (emotional system), which includes essential information on a cortical portion of the limbic system, the prefrontal cortex and the executive function systems.

Professional Ignorance

I am only assigning you Dr. Sapolsky’s Stanford lecture on the Limbic System.  I do that with post-docs, I “assign” some material, and I “recommend” other material, the difference being direct relevance and indirectly important.

You should watch them all.  You will only be using the knowledge about the limbic system when you reach the material from Stern, Shore, Tronick, Trevarthan, van der Kolk – and others – attend also to the Polyvagal Theory and Porges.

Notice something important at the start of Dr. Sapolsky’s Limbic System lecture.  It is a week before the midterm and the material about the limbic system is not going to be on the midterm.  Dr. Sapolsky nonchalantly comments on a number of empty seats.

There are two types of humans, and they are reflected in the students’ decisions.  One group, “Is this going to be on the midterm?” and if not, then they disregard the knowledge that they will need as professionals, because it is not directly relevant to their task at the moment, passing the midterm exam.

This failure in frontal lobe systems surrounding time projection, called foresight and planning, indicates unresolved traumas in other regions of the prefrontal cortex and limbic system that is inhibiting full activation of frontal lobe executive function systems – or – developmentally appropriate maturational processes during the 18-to-24 period. 

The students that skipped the class did not have the frontal lobe capability “to do the hard thing” (attend class) “when it is the right thing to do” (learn knowledge).  The students came to Stanford University, a top-tier educational institution, to learn.  Yet they do not attend class because the material is “not on the midterm.” 

A very “now” orientation to their motivation.  Is this going to help me… now?  The frontal lobe systems for foresight and the inhibition of other competing limic systems activity driving motivation has not yet fully developed.  That’s relatively normal for that age period.  The frontal lobe does not complete its maturation until age 25.

Other students attended. Even though they weren’t going to be “tested” on the information, they came to learn the information.  They understand the value of the information, that’s what they came to Stanford University for, the knowledge. They want this knowledge because it then serves as a foundation for the next set of knowledge, and they will need this next set of knowledge for the tasks they will undertake professionally. 

Do you see the difference between a limic brain of motivation that’s oriented toward the now, and the executive function systems of the prefrontal cortex that inhibit limic activity to allow us to “do the hard thing, when it’s the right thing to do.”

Ignorance is Not Acceptable with Children

To my professional colleagues, you are working with children. Their lives are in your hands. Your ignorance can destroy their life trajectories, or it can fulfill and enrich the entire future course of their lives, and the lives of their spouses and children.  Their future is in your hands – in your ignorance or your knowledge.

What reason do you have for ignorance and sloth?  Is any level of ignorance and sloth acceptable when working with the lives of children?

The court also holds the lives of these parents and their children in the balance of its decisions, lives will be changed, potentially destroyed or saved, by the court’s decision.  The court is seeking consultation from professional psychology for recommendations supporting the child’s healthy development – the “best interests of the child.”

The court is coming to you.  You hold the lives of these children and the lives of these parents in your hands, in the difference between your ignorance and knowledge.

The Limbic System is on my midterm, the midterm of Dr. Childress for professional competence in working with children, especially emotionally dysregulated children – that’s the limbic-prefrontal cortex network.  You will need this information for the information on intersubjectivity, attunement, emotional regulation, and complex trauma that will follow next. That is the information you need to know; Stern, Tronick, Trevarthan, van der Kolk, Fonagy, Shore, Lyons-Ruth, and others.

The rest of Sapolsky’s Standford University lectures are not on the midterm of Dr. Childress.  Bear in mind that I already know the material.  I watched them anyway, and I learned more.  Because ignorance is never acceptable when working with children.

What’s your excuse for your ignorance?  Is understanding child development not important to working with children?  Is understanding the neuro-development of the brain too difficult? 

Then you are ignorant of child development, and you need to go away and not work with children, or you should follow the instructions of people who are not ignorant and who do understand child development – including the neuro-social development of the brain across its various phases and processes.

Do you understand intersubjectivty?  “What’s that?” you say.  I know.  You don’t know what that is, do you?  You don’t know what you’re doing, do you?… I know.  That’s a problem.

Do you understand the roles of attunement and misattunement in the joint construction of meaning?  Do you understand the processes of affect regulation and dysregulation, and its treatment?  Do you understand the neuro-social processes of identity formation and stabilization within the variations across the developmental stages of childhood? 

If not, then I cannot even have a professional-level discussion with you.  You are too ignorant (lacking knowledge or information).

You do not understand child development, the scientific research on child development… you don’t know any of it.  That’s a serious problem if you are working with children whose lives hang in the balance of your knowledge or ignorance… because you’re ignorant.

Dr. Sapolsky’s class is an undergraduate course.  You are not even at the level of an undergraduate student if I cannot discuss the role of the limbic brain, particularly and especially the amygdala, prefrontal cortex, and the vagus nerve of the autonomic nervous system.

I have to first educate you in order to have a professional-level discussion with you. That’s not okay.  I shouldn’t have to educate you, you should already be educated before – before – you start to work with children.

Start with van der Kolk’s two day course-seminar from PESI in trauma and complex trauma.  As a preliminary assignment, watch Sapolsky’s Stanford University lecture on the Limbic System.  Google Polyvagal Theory; Porges.   You will ultimately be headed toward Tronick and Stern (intersubjectivity), this will include Trevarthan and Fonagy.

Oh… know Bowlby.  Read all three volumes on attachment, know Lyons-Ruth, buy and know the Handbook on Attachment.

I would consider all of this an assignment for a post-doc.  If you do not know this information, you are not ready to begin work with children… you are not ready to even – begin – not even begin – your work with children if you do not know this information about child development.  You are ignorant, which means you will be incompetent.

If you were my post-doc and didn’t know this information, I would not let you have patient contact until you knew this information.  Not only would I be supervising your work because you’re still in training, I wouldn’t even let you work with child patients until you knew this information.

Google ignorance: lack of knowledge or information

Do you know Sapolsky and van der Kolk?  Cicchetti and Lyons-Ruth?  Stern and Tronick?  Then you lack knowledge or information, you are ignorant.

Ignorance solves nothing. Ignorance is unacceptable professional practice when you hold the lives of children in the balance of your knowledge and ignorance.

Google incompetence: inability to do something successfully; ineptitude.

Can you resolve interpersonal conflict?  Then do it.  You can’t, can you.

You can’t do it because you lack knowledge about how to do it, about how to resolve conflict.  You are ignorant.  And because of your ignorance, you are unable to solve the parent-child conflict, you are unsuccessful, you are incompetent.

Google sloth: reluctance to work or make an effort; laziness.

Have you watched Sapolsky’s Stanford University lecture on the limic system, available for free on YouTube?  Have you watched all of Dr. Sapolsky’s Standford University course lectures?  Have you taken Bessel van der Kolk’s two-day course from PESI on trauma and complex trauma?  Or are you reluctant to work and make an effort? Are you lazy and slothful?

Google negligence: failure to take proper care in doing something; (law) failure to use reasonable care, resulting in damage or injury to another.

Did you use proper care?  Or are you ignorant, incompetent, and slothful?  Did your ignorance, incompetence, and professional sloth result in injury to the parent, harm and damage to the child?

Do any of those words apply to you?  Ignorance, incompetence, sloth, or negligence?

Do you lack information and knowledge, are you unable to solve the family conflict because you lack knowledge and information about how to do that, and do you fail to know this knowledge and information because you are reluctant to make an effort, you’re lazy, and then this causes harm, causes injury to the child and the parent, because you failed to take proper care in first learning about child development and parent-child conflict and bonding – before – you started to work with children.

None of those words apply to me.  I work with children.  None of those words apply to me.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

Complex Trauma & Bessel van der Kolk

Professional practice with court-involved family conflict surrounding divorce requires competence in five domains of professional psychology:

  • Attachment
  • Family systems therapy
  • Personality Disorders
  • Complex trauma
  • Neurodevelopment in childhood

Leading figures in each of these domains would be:

John Bowlby, Mary Ainsworth: attachment

Salvador Minuchin, Murray Bowen: family systems therapy

Aaron Beck, Otto Kernberg, Theodore Millon, Marsha Linehan: personality disorders

Bessel van der Kolk: complex trauma

Edward Tronick, Daniel Stern: neurodevelopment of the brain

Trauma & Complex Trauma

Professional competence in the educational curriculium for trauma and complex trauma can be gained, and demonstrated on the vitae, through the PESI 2-day Continuing Education course from Bessel van der Kolk:

Bessel van der Kolk: The Body Keeps Score

It is my strong professional recommendation that all mental health professionals working with court-involved family conflict take this Continuing Education course from PESI to acquire and demonstrate current educational curriculum knowledge regarding trauma and complex trauma.

This two-day course from Bessel van der Kolk would not satisfy practice requirements as a trauma therapist, but would be sufficient for court-involved family conflict mental health professionals. Of note is that PESI offers a separate 75 hour Certificate Program in Traumatic Stress Studies.

Also of note regarding additional information, training, and competency in trauma and complex trauma is the National Child Traumatic Stress Network.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

 

 

AFCC: Class Action Exposure?

The Association of Family and Conciliation Courts (AFCC),is the professional organization for forensic psychologists and family law attorneys.  The AFCC specifically instructs child custody evaluators NOT to diagnose pathology.

The AFCC has published an instruction guide for child custody evaluations, the Model Standards of Practice for Child Custody Evaluations.

With this document, the AFCC has put their seal of approval, their imprimatur, on the practice of child custody evaluations.  I believe that is significant, because I wonder what sort of legal liability that establishes for the AFCC regarding the assessment procedure of child custody evaluation.

I’m not a lawyer, but as a psychologist I’d be worried if I were on the Board of Directors for the AFCC about the potential legal liability exposure this “Model Standards of Practice” creates for our organization.  If we’re telling people how to do it, and providing our professional credibility, name and status to the activity, then to what extent do we also incur legal liability responsibility for endorsing and recommending the practice?

If I’m on the Board of Directors as a clinical psychologist, I’m going to want our attorneys to offer an opinion on that, and I’ll want our attorneys to review our “Model Standards of Practice” with an eye toward legal liability exposure before we publish them and provide our organization’s imprimatur of support for the practice.

And, on the other hand, if I’m considering a class action lawsuit against the practice of child custody evaluations for essentially being a fraudulent financial racket (I’m not a lawyer, but if I were, I’d seriously look at a Rico violation with the AFCC as the organizing syndicate and the child custody evaluators as the capos), I’d be looking at linking the AFCC to the lawsuit specifically on this document, their Model Standards of Practice for Child Custody Evaluations.

Seems to me… they took ownership of the practice of child custody evaluations with that document.

Principle D Justice

The first problem the AFCC faces is that the practice of child custody evaluations is a foundational violation of Principle D Justice of the American Psychological Association ethics code.  Child custody evaluations, as a practice, are in violation of a foundational Principle of ethical practice, Justice, on two separate and independent counts.

Principle D: Justice
Psychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists.  Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices.

Let’s begin to apply this Principle of professional ethics to the practice of child custody evaluations…

“fairness and justice entitle all persons to access to and benefit from …”

A typical child custody procedure costs between $20,000 to $40,000 for each evaluation. That financial cost places the practice of child custody evaluation beyond the affordability of all but the most affluent of families.  Since lower-income families are offered no alternative, they must turn to substandard assessments conducted by less qualified, and often unqualified, professionals because the more qualified professionals and assessments are cost-prohibitive.

The most expensive clinical psychology assessment for the most complicated child pathology (e.g., trauma with autism-spectrum and ADHD features, learning disabilities, involving prenatal exposure to drugs, foster care placement, and current behavioral problems) would cost around $5,000 and take between four to six weeks to complete, with a report, for a high-end comprehensive assessment.  A typical clinical psychology assessment for most pathologies costs about $2,500.

That forensic psychology cannot develop an assessment protocol for their “high-conflict divorce” pathology for less than $20,000 to $40,000 strains credulity, and raises prominent professional concerns about their exploitation of a vulnerable population, the class of parents in family court litigation surrounding child custody and visitation schedules.

Forensic psychology claims this population as their exclusive property, prohibiting any recommendation for child custody visitation schedules being offered by clinical psychologists based on any criteria OTHER than the conduct of their $20,000 to $40,000 child custody evaluation procedure.

As a treating clinical psychologist with full, direct, and ongoing knowledge of the pathology in the family, I can form a professional opinion on the relative benefits of different custody visitation schedules… I just can’t tell the court my opinion.  I am prohibited from telling the court my opinion unless I’ve conducted one of their $20,000 to $40,000 child custody evaluations.  Then I can tell the court my opinion.

Parents who cannot afford the excessive and obscene cost of a child custody evaluation are denied “access to and benefit from” quality professional input into their family litigation and the court’s decision-making.  That is a fundamental violation of Principle D… “fairness and justice entitle all persons to access to and benefit from …”, less affluent families are being denied “access to and benefit from ” the input of professional psychology.

The practice of child custody evaluations, endorsed with guidelines from the AFCC, is foundationally in violation of Principle D Justice of the APA ethics code for denying “access to and benefit from” quality professional input into their court-involved family conflict because the excessive and prohibitive financial cost of their immensely bloated and ill-conceived assessment procedures.

“fairness and justice entitle all persons to… equal quality in the processes, procedures, and services being conducted by psychologists.”

There is no inter-rater reliability to child custody evaluations.  This means that child cusody evaluations are not a valid assessment of anything, they are just the opinion of one person, the evaluator, based on no supported foundations.

The absence of inter-rater reliability means that different evaluators can reach entirely different conclusions and recommendations based on exactly the same family information and data.  Families are therefore denied “equal quality in the processes, procedures, and services” by the absence of inter-rater reliability to the procedure.

Two of the prominent experts in forensic psychology, Stahl and Simon, who literally wrote the book on child custody evaluations, published by the Family Law Section of the American Bar Association, acknowledge the high degree of variability in the quality of “services” delivered by child custody evaluators.

From Stahl & Simons: “The American Board of Forensic Psychology is a subspecialty board of the ABPP. In the fall of 2011, there were approximately 250-300 ABPP board certified forensic psychologists in the United States and an unknown number of psychologists who specialize in forensic work but are not board certified.  On top of that, there are many psychologists who dabble in forensic practice, occasionally performing child custody or other types of forensic evaluations, and who find themselves called to testify in court on occasion.  While we recognize that there is a range of quality in their work, it is clear that forensic psychology is a growing area of specialization.” (Stahl & Simons, 2013, p. 9)

Stahl, P.M. and Simon, R.A. (2013). Forensic Psychology Consultation in Child Custody Litigation: A Handbook for Work Product Review, Case Preparation, and Expert Testimony, Chicago, IL: Section of Family Law of the American Bar Association

The procedure of child custody evaluations violates Principle D Justice of the APA ethics code by failing to provide “equal quality in the processes, procedures, and services being conducted by psychologists.”  This is an openly acknowledge fact (“we recognize that there is a range of quality in their work”; Stahl & Simon, 2013).

To the extent that the AFCC issues Model Standards of Practice for Child Custody Evaluations they are providing recommended “Standards of Practice” for an unethical procedure.

Avoiding Diagnosis

Diagnosis is considered professional standard of practice in all cases.  Diagnosis guides treatment.  The treatment for cancer is different than the treatment for diabetes.  In order to develop a treatment plan and recommendations (any recommendations), we must first know what the pathology is, what’s the diagnosis?

The treatment for cancer is different than the treatment for diabetes.  Diagnosis guides treatment.

How can we possibly know what to do about a problem, until we first identify what that problem is.  The term “identify” is the common-language word for the professional term “diagnosis.”  We must first identify what the problem is in order to know how to fix it; we must first diagnose what the problem is in order to know how to treat it.

identify = diagnosis

fix = treatment

It is professional standard of practice to first diagnose (identify) the pathology before offering any recommendations about what to do.  If we don’t know what the problem is, if we haven’t identified (diagnosed) what the problem is, how can we possibly know what to do about it?

Failure to first diagnose (identify) what the pathology is prior to making recommendations about how to fix it (treatment or remedy) would be a violation of Standard 9.01a of the APA ethics code requiring that;

Standard 9.01a 9.01 Bases for Assessments
(a) Psychologists base the opinions contained in their recommendations, reports, and diagnostic or evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate their findings. (See also Standard 2.04, Bases for Scientific and Professional Judgments.)

If the assessing evaluator has NOT even identified what the problem is (diagnosis), then the recommendations contained in their “reports, and diagnostic or evaluative statements, including forensic testimony” are not based on information “sufficient to substantiate their findings” because they don’t even know what the pathology is – they have not yet even identified – diagnosed – what the problem is.

In addition, the Model Standards of Practice for Child Custody Evaluations from the AFCC specifically instruct child custody evaluators to AVOID making a diagnosis.

4.6 Presentation of Findings and Opinions
(c) Evaluators recognize that the use of diagnostic labels can divert attention from the focus of the evaluation (namely, the functional abilities of the litigants whose disputes are before the court) and that such labels are often more prejudicial than probative.

While not directly prohibiting child custody evaluators from identifying what the pathology is (the “diagnostic label”) prior to offering recommendations to the court, the clear indication from the AFCC is that identifying pathology (the “diagnostic label”) is “often more prejudicial than probative” and should be avoided, because it “diverts attention” from the true focus of the assessment, which must be something other than identifying what the problem is and offering recommendations on how to solve it.

Diagnosis guides treatment.  We do not know what to do about a problem until we first identify (diagnose) what that problem is.  The treatment for cancer is different than the treatment for diabetes.

In addition to the deeply troubling prominent encouragement from the AFCC to avoid diagnosing pathology before making recommendations to the court, is the further troubling assertion from the AFCC that child custody evaluators should strive to influence the court’s decision-making by withholding from the court information about pathology that the custody evaluator thinks might be “prejudicial” to the case of the pathological parent.

The AFCC is recommending that the child custody evaluator preempts  the court’s authority to assess the relative value of a “diagnostic label” (identifying what the problem is), and that the child custody evaluator should instead independently weigh the relative “prejudicial” and “probative” value of disclosing to the court the identifying name for the pathology in a family, apparently to influence the court’s decision in favor of the pathological parent by withholding diagnostic information from the court’s consideration.

It is a deeply troubling role for a child custody evaluator to be making preemptive decisions on the relative prejudicial and probative value of diagnostic information in order to then withhold information from the court’s consideration that will influence the court’s decision in favor of a pathological parent, based solely on a decision made by the custody evaluator regarding the relative prejudicial and probative value of the information.

Not only is this diagnostic information withheld from the court’s consideration, it is also not disclosed to the parties.  This violates the rights of the non-pathological parent to present evidence to the court because the relevant evidence is being arbitrarily withheld from disclosure to the parent by the child custody evaluator, based on instructions made to the evaluator from the AFCC in their Model Standards of Practice for Child Custody Evaluations, Standard 4.6(c).

In issuing Model Standards of Practice for Child Custody Evaluations, to what degree has the AFCC assumed legal liability for the practice of child custody evaluations?

Principle D Justice
“Psychologists… take precautions to ensure that their potential biases, the boundaries of their competence, and the limitations of their expertise do not lead to or condone unjust practices.”

How?

How have child custody evaluators taken “precautions” to limit their “potential biases“?  What specific precautions in the child custody interview process has that child custody evaluator taken to limit the “potential biases” of the evaluator?

The mother in the case reminds the evaluator of his ex-wife, the tone of her voice, what she says.  She’s really irritating.  The custody evaluator doesn’t agree with the cultural parenting practices and values of one of the parents, he just doesn’t think that’s the right way to parent.

What precautions did that child custody evaluator take in that evaluation to limit the potential biases – many of them unconscious biases (the evaluator may have mommy-issues or daddy-issues, may have been sexually abused as a child and harbor unconscious anger toward “abusive men”).

What type of “precautions” are taken?  None.

Child custody evaluations take NO precautions to limit “potential bias.”

What “precautions” did the custody evaluator take to ensure boundaries of competence?

This is an attachment pathology, a child rejecting a parent.  Where on the custody evaluator’s vitae does it demonstrate background training and experience in assessing, diagnosing, and treating attachment pathology?

This is a family conflict pathology.  Where on the custody evaluator’s vitae does it demonstrate background training and experience in family systems therapy.  Or do they assert that family systems therapy, one of the four primary schools of therapy and the only one dealing with families… is not relevant to boundaries of competence.

Do they believe that knowing about families and how families function is not required knowledge for assessing, diagnosing, and treating family conflict pathology?

How has the custody evaluator taken “precautions” to ensure their boundaries of competence?  What precautions?

“…do not lead to or condone unjust practices.”

Do you mean like denying people “equal access to and benefit from the contributions of psychology and to equal quality in the processes, procedures, and services being conducted by psychologists”? 

That type of “unjust practice”?

In issuing Model Standards of Practice for Child Custody Evaluations, and placing their professional endorsement and imprimatur of credibility onto the practice of child custody evaluations, to what degree has the AFCC incurred legal liability relative to the practice of child custody evaluations in forensic psychology?

I don’t know, I’m not a lawyer.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857